In British Columbia, the
Health Care (Consent) and Care Facility (Admission) Act sets out that, in most situations, health care providers must obtain informed consent prior to administering a health care treatment.
With the provincial COVID-19 immunization strategy currently underway, health care providers are in the process of obtaining informed consent prior to administering the vaccine. In some situations, the Public Guardian and Trustee (PGT) may provide consent on behalf of adults who are not capable of providing consent themselves. To learn more about the PGT's role under the
Act, click
here.
Informed Consent and the COVID-19 Vaccine FAQs
Who has the legal authority to provide consent to the COVID-19 vaccine?
How does the PGT decide whether to provide consent to the COVID-19 vaccine?
Is there a prescribed consent form that must be signed?
Does consent to the COVID-19 vaccine expire after 21 days?
Can a physician provide consent on behalf of an adult?
Can a paid caregiver provide consent on behalf of an adult?
How do I contact the PGT?
Who has the legal authority to provide consent to the COVID-19 vaccine?
The
Health Care (Consent) and Care Facility (Admission) Act sets out what informed consent entails and who may make a health care decision. The following is a list in ranked order of who may provide consent to a health care treatment. If the adult or substitute is incapable or unavailable to make a decision, the health care provider moves down the ranked order to select a substitute.
1) An adult may provide consent if they are capable of making the decision.
- All adults are presumed to be capable of providing consent themselves unless a health care provider determines them to be incapable.
- An adult's representative, family or close friend may support them to make this decision.
- A valid advanced directive may provide consent. Click
here to learn more about advanced directives.
2) An adult's personal guardian – known as a committee of person in British Columbia – may provide consent on the adult's behalf.
- The Supreme Court of British Columbia appoints a committee of person when an adult is declared to be incapable of making personal and health care decisions. Click
here for more information.
3) An adult's representative may provide consent on the adult's behalf.
- An adult may appoint a person to make health care decisions on their behalf through a Section 9 Representation Agreement or a Section 7 Representation Agreement that authorizes the representative to make minor health care decisions. Click
here for more information.
4) An adult's Temporary Substitute Decision Maker (TSDM) may provide consent on the adult's behalf.
- When a health care provider has determined an adult to be incapable of providing informed consent to the vaccine and there is no committee of person or representative, the health care provider selects a person who meets the criteria of a TSDM, in the following ranked order:
- the adult's spouse;
- the adult's child;
- the adult's parent;
- the adult's sibling;
- the adult's grandparent;
- the adult's grandchild;
- anyone else related by birth or adoption to the adult;
- a close friend of the adult;
- a person immediately related to the adult by marriage; and
- the Public Guardian and Trustee
Click
here for more information for temporary substitute decision makers.
5) The Public Guardian and Trustee
- When a health care provider has determined an adult to be incapable of providing informed consent to the vaccine and no family or friends are willing, able or qualified to act as TSDM, the PGT may make the decision on the adult's behalf.
How does the PGT decide whether to provide consent to the COVID-19 vaccine?
The PGT adheres to the duties of a TSDM as set out under the Health Care (Consent) and Care Facility (Admission)
Act. Where possible, the PGT consults with the adult and any person who is involved in the adult's care to gather information about the adult and whether they expressed a prior capable wish that would apply to the COVID-19 vaccine.
If the adult has not expressed any relevant prior capable wishes, the PGT makes a decision that is in the best interests of the adult taking into account their current wishes, the benefits and risks of the vaccine and whether there are any contraindications or risk factors unique to the adult's situation.
The PGT relies on the expertise of health care providers, service providers and physicians to inform this decision, including the advice and direction from the
BC Centre for Disease Control.
Is there a prescribed consent form that must be signed?
There is no prescribed consent form that must be used when providing consent to the COVID-19 vaccine.
The
Health Care (Consent) and Care Facility (Admission) Act sets out that consent may be provided orally or in writing. The
BC Centre for Disease Control provides a link to a
consent form for immunizations that may be used to record substitute consent to the COVID-19 vaccine.
When acting as TSDM, the PGT provides consent on a separate letter that describes the PGT's role and specifies the consent details.
Does consent to the COVID-19 vaccine expire after 21 days?
As TSDM, the PGT provides consent to the COVID-19 vaccine as part of a health care plan that expires one year after the date of consent. Any TSDM has the legal authority to provide consent to a health care plan in this manner.
Can a physician provide consent on behalf of an adult?
A physician does not have the legal authority to provide consent to a health care treatment as set out under the
Health Care (Consent) and Care (Facility) Admission Act. There are some exceptions where a health care provider may waive the requirement to obtain consent such as the provision of health care treatment in urgent and emergency situations in order to preserve life, prevent serious harm or alleviate severe pain.
Can a paid caregiver provide consent on behalf of an adult?
A paid caregiver who is not a family member does not have the legal authority to provide consent to a health care treatment as set out under the
Health Care (Consent) and Care Facility (Admission) Act. When acting as TSDM, the PGT recognizes the unique care relationship between service providers and the adults they provide care to and will make every attempt to involve the service provider in the decision-making process.
How do I contact the PGT?
The Personal Decision Services (PDS) department responds to requests for consent to all health care decisions. The department may be reached by:
Telephone: 1-877-511-4111
Fax: 604-660-9479
Email:
AIS-PDS@trustee.bc.ca
